Scene x MHPA Webinar | Harnessing Member-Centric Strategies to Support Members with Complex Conditions

Caring for individuals with complex needs demands a patient-centric approach, with engagement emerging as the linchpin for success. This was the foundation of our latest Medicaid Health Plans of America (MHPA) panel discussion between a diverse group of health plan leaders, Medicaid directors, and healthcare experts.

Their insightful conversation touched upon several key themes:

When it comes to engagement, the whole is greater than the sum of its parts

“The word engagement holds a lot of promise. It’s meaningful. It’s not a unit of measurement for billing. Our tech, based on an in-person concept called Directly Observed Therapy, enables that engagement. But in the end, it’s really all about our care team and the relationships they build with members. They care. They really, really, really care.” — Sebastian Seiguer, CEO and Co-Founder of Scene Health

“Engagement is each interaction, a call, a visit to a provider, a letter, an email, a conversation. It’s an opportunity to build trust and make sure members have the information needed to make choices...it is relatable and provides hope.” — Kerianne Johnstin Guth, MSW, Clinical Strategy Director of Adult Chronic Conditions & Care Management at UnitedHealthcare Community & State

“For us, it's about a member getting connected to care. We want to get our members as early in the care journey as possible. They may not have a condition now, but that may change later. It’s about assisting them with actions and decisions to get them on a path to wellness. Partners like Scene and our care management team are part of that.” — Sheila Yahyazadeh, MPA, PMP, Chief External Operations Officer of CareFirst Community Health Plan Maryland

Engagement starts with trust and connection

“When you think about engaging with communities, the opportunity to have more relatability and trust can make engagement unstoppable. Community-driven and community-led engagement is where we really need to be. It’s a huge opportunity and a huge privilege for us.”  — Kerianne Johnstin Guth, MSW, Clinical Strategy Director of Adult Chronic Conditions & Care Management at UnitedHealthcare Community & State

“Individuals are experts in their own care. That’s something frontline staff or the C-suite can appreciate. We should be moving to ask the people we serve not, “What’s wrong with you?” but, “How are you?” — Kerianne Johnstin Guth, MSW, Clinical Strategy Director of Adult Chronic Conditions & Care Management at UnitedHealthcare Community & State

“When we’re working with partners like Scene, it’s more to alleviate their emotional and cognitive load. They get to talk about their day and build relationships so they can understand what they need to do to get better. We need to understand members and what they’re going through beyond adherence.” — Sheila Yahyazadeh, MPA, PMP, Chief External Operations Officer of CareFirst Community Health Plan Maryland

And trust can be amplified through technology

“Are you hearing from a messenger who looks like you, sounds like you, etc? This can be done with technology. Language, culture, and context is the key to building trust. All this starts with an algorithm, but humans are non-linear. Who are the holders of that trust? Who around the individual has trust that you can activate? Who is the right trusted messenger to carry the message to the member?” — Jim Hickman, MBA, Principal at Hickman Strategies and  CalAIM Advisor at the Camden Coalition

“Person-centered care gives us a framework, principles, values, and culture. It helps us think about what kind of artifacts, tools, and materials come from our programs. And I think tech is one of the best tools we have in our toolkit to keep our values aligned with person and trauma-informed care.”  — Kerianne Johnstin Guth, MSW, Clinical Strategy Director of Adult Chronic Conditions & Care Management at UnitedHealthcare Community & State

But personal connections are still paramount

“You can have all the data, but it’s still that human touch and interaction that gets us to the last mile.” — Sheila Yahyazadeh, MPA, PMP, Chief External Operations Officer of CareFirst Community Health Plan Maryland

“I feel for colleagues in managed care because you have people outside your doors telling you AI can slice and dice and help your members. To me, AI and predictive modeling, at the end of the day, generates a list. But how do you activate data? A code does not give you a real picture of what’s going on in the community. We need to make data actionable and meaningful to the individual. And going the last mile..we’re seeing a lot around community health workers. All this AI data is ending up at the endpoint with an individual, and a human confirms the data and the needs.” — Jim Hickman, MBA, Principal at Hickman Strategies and  CalAIM Advisor at the Camden Coalition

“I think until AI can make an emotional connection, we’re still in the business of human touch.” — Sheila Yahyazadeh, MPA, PMP, Chief External Operations Officer of CareFirst Community Health Plan Maryland

Overall, there’s a need for synergy

“We talk about whole person health, but we are not operating as a whole system. There needs to be an evolution towards that, and there are things we can do in partnership with Scene and other vendors.”  — Sheila Yahyazadeh, MPA, PMP, Chief External Operations Officer of CareFirst Community Health Plan Maryland

Moving forward

The conversation was a valuable exploration of the power of member engagement to support members with complex conditions. The panelists shared real-life examples of the impact that personalized support can have on members' health outcomes and overall costs.

It was a profound reminder that human connections and meaningful relationships are the most potent tools in health plans' arsenal to improve outcomes. Moving forward, health plan leaders must prioritize providing customized support to members with multiple chronic conditions who would benefit the most from the additional engagement.

Thanks to the panelists who joined us and shared their insights. We left the conversation feeling inspired to expand our work of providing medication engagement to the most vulnerable populations.

Watch the full webinar recording: